HomeMy WebLinkAbout1999-011563 (Septic) PERMIT
CITY OF ORONO PERMIT TYPE:
275q Kelley Parkway- P.O. Box 66 =.L i�:;:i;� �, i�.i}::,j�_;;
Crystal Bay, Minnesota 55323 Permit Number:
Date Issued: � � �r����
r!�12) 473-7357 � _ ;'i � .''t'=�
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: -- ��s��� _;.�x�?. — OWNER:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CTl''X OF .ORONO SEPTICSYSTEI�IPERi��IITAPPLICA3TIO�t �
;�ox 66 (2750 Kelley Parkway) �
Crystal Bay, 11�L�I �5323 � - .
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JOB SITE ADDRESS: . . .
Occupanci• Type: � Residential` ' Commercial �. . Other �
Permit T��pe: h'e�v or Repiacement System, �100.00 �
Repair E�stina System, � 50.00
(Tanks or Drainf eId)
0.50 State surcharge added to above fees �
. *See fee schedule for non-residential permit fees
O�vner's Iti'ame: , • Phone\Tumber: �
iVlailina Address: City: �P_ �---
Contractor's I�Tame. PhoneI�Tumber:
iYiailing Address: City: �P�________---
DO 1TOT tiIA-� P��•�NT ��TTH THIS APPLICATIOti' -
GE�rERA�L IYSTRUCTIONS � � � �
�, Applicacions for septic�sysczm permics may be mailed or submired i.n person at the Ciry
Offices; howevzr, permits will not be.mailed out. The permit must be picked up in
person at the City Offices and work must not be�in unless the permit card is on the job
site. � .
2, pennits will bz issued only to contraccors holdin� a City oi Orono Septic System
Installers License.
3, AlI work must be done in accordance tivith the approved sep[ic system desi�n. Design
reports are not considered approved unless accompanied by the "City of Orono Septic
System Approval" cover sheet si�ned by the City InsPeccor.
4, : The followin� inspeccions will be required for all septic systems: _ _ .. �
� � A, pre-installation site inspection to include inspector, installer, and general contra.ctor.
B. Tank iastallation prior to cover'in�.
C. Dra'u-lfield trench installation prior to coverin�. For mounds, inspeetion is reqciired
afcer rouQh-up but grior to sand placemenc (sand will be jar tested for silt content),
� and a�ai.n durin� pressure distribution pipin� installation in � rock b P• S�tion
D. F i a a l i n s P e c t i o n t o v e ri f y p r o per fmal cover de pchs and to veri that all umP
(where required) components are functional and comply with codes.
5, Iridividual holdin�MPCA Installer Certifica[e shall be presenc durin� inspections: A 2`�"
hour notice is required for all inspections.
N07'E: �Applicant rriust i.n.itial aII spaces. FilI in alI appropriate blanks, check all appro riate '
boxes. . p
1. T have received a copy of the system desi�n includin� the Ciry of Orono
Septic System Approval Cover Sheet. �
.2. I tivill�be�installin� thz followin?;'� � . .
A. Tanks: Precast Concre[e Ocher i1�lannfacturer
Tank Capacities: 1) ' gai. 2) �al. ^ :
a ,� a21, .
- B• Pump Station (if required)
Pump make & model : - � (attach pump curve &
literature); system design rzquires gpm at - feet of head.
Hi;h water alarm make & model
• ' electrical work to be compieted by installer + • Outside
ocher eiecerician
. Inside electrical work must be compleced by
electrician. �
' C. Treatment System:
� Trenches: s.f. Mound
Depth of rock below pipe " Rock bed dimensions 'x - °
� Dro p Boxes � Sand bed dimensions , 'x � -
Distribution Box Pressure Dis[. Pipe Diam. � "
� .Maniford Pipe Diam. ^
D. Final Cover/Topsoil to be: borrowed from site
(show location on site pla�)- �
„ ��, trucked in
The undersi�ned hereby applies to the City of Orono for issuance of a septic system installation
permit, a�rees to do all work in strict accordance with the ordinances of the Ciry and the
regulations of the State of Minnesota, and certifes ihac all statements made on this application
are complete, true and correct:
Si�natureofAppIicant: Date: . � '
MPCA Certification No.: " ' . � . - •
Staff RevieSv: Appr �`-- Deni . . �
� ReFiesver: ''� . � . .
� Date:�--/'j��
�
Reason for Denial•